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GAO-01-1046R 1 (2001-08-17)

handle is hein.gao/gaocrptamuk0001 and id is 1 raw text is: SGAO Accountability * Integrity Reliability United States General Accounting Office Washington, DC 20548 August 17, 2001 The Honorable Michael Bilirakis Chairman The Honorable Sherrod Brown Ranking Minority Member Subcommittee on Health Committee on Energy and Commerce House of Representatives The Honorable Jim Greenwood Chairman The Honorable Peter Deutsch Ranking Minority Member Subcommittee on Oversight and Investigations Committee on Energy and Commerce House of Representatives Subject: Medicare: Comments on HHS' Claims Administration Contracting Reform Proposal On June 28, 2001, I testified before your subcommittees that the Medicare program could benefit from reformed claims administration contracting authority and practice.' On the same day, the Secretary of Health and Human Services (HHS) submitted a legislative proposal that would modify Medicare's contracting authority. You asked us to comment on whether the proposal gives the Centers for Medicare and Medicaid Services (CMS)2 -the agency within HHS that manages Medicare-the flexibility to promote better performance and accountability in its contracting activities. Accordingly, this correspondence discusses (1) current law and practice in Medicare claims administration contracting, (2) provisions in the proposal that would increase CMS' contracting flexibility, and (3) provisions that deviate from standard federal contracting requirements for full and open competition and indemnification of contractors. In brief, due to statute and long-standing practice, Medicare claims administration contracting does not follow standard federal contracting rules in a number of ways. ' Medicare Contracting Reform: Opportunities and Challenges in Contracting for Claims Administration Services (GAO-0 1-9 18T, June 28, 2001). 2 CMS was known until recently as the Health Care Financing Administration. 3 The Secretary has delegated authority to administer the Medicare program, including managing claims administration contractors, to CMS. GAO-01-1046R Medicare Contracting Reform Proposal

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